Cognitive Change Clinical Trial
Official title:
The Effect of Acute Minocycline Administration on Emotional Processing and Cognition in Healthy Volunteers
There is growing interest in the possibility of producing more effective antidepressant treatments that target a wider range of pathways involved in depression, including anti-inflammatory and anti-glutamatergic systems. Minocycline is a novel pharmacological agent; in addition to its antibiotic and anti-inflammatory properties, it also acts in the brain as an anti-glutamatergic and anti-oxidant agent. Since both excessive glutamate and oxidative stress are implicated in major depression, and appear to be connected to pro-inflammatory activity, this drug offers a unique tool with which the investigators can measure the effects of targeting these pathways on emotional processing. Participants will receive a single dose of either the drug (200 mg minocycline) or placebo, and will then undergo a well-validated computerised battery of emotional processing tasks that have previously been shown to be sensitive to standard antidepressant drugs. Tasks include presentation of positive and negative emotional words or pictures, to which participants' responses are measured. These tasks have been widely used previously without any adverse effects.
Current antidepressant treatments, which largely target monoamine pathways, are efficacious
in treating many aspects of major depression, however it is estimated that more than 30% of
depressed patients fail to respond to standard antidepressant medications. Thus, there is a
strong clinical need to identify and investigate novel treatment strategies that target
different pathways involved in the pathophysiology of mood disorders. Mounting evidence
indicates a potentially important role of inflammation in major depression; both clinical and
animal studies have shown that pro-inflammatory cytokines can induce a behavioural repertoire
of symptoms collectively referred to as 'sickness behaviours,' which include cognitive and
mood symptoms, such as depression, anxiety, memory impairment, fatigue and anhedonia.
Furthermore, elevated levels of peripheral pro-inflammatory cytokines, such as tumour
necrosis factor (TNF)-α and interleukin (IL)-6, have been consistently reported in clinical
mood disorders, including major depression. Evidence also points to the ability of
pro-inflammatory cytokines to cause excitotoxicity (due to increased release of glutamate)
and oxidative stress that are strongly implicated in the pathophysiology of major depression.
Such evidence has therefore led to growing interest in testing effects of anti-inflammatory
treatments on mood and emotional function to investigate whether the inflammatory-mood
pathway could represent a novel drug target for new antidepressant therapies.
Minocycline has been selected for use in the present study as it is a pharmacologically
interesting agent with an unusual combination of anti-inflammatory activity, in addition to
anti-glutamatergic, anti-oxidant and neuro-protective actions. Thus, owing to its central
action on systems that are thought to be involved in major depression, minocycline provides
an interesting tool to investigate effects on cognition and emotional processing,
particularly negative affective biases.
Negative affective biases in emotional processing are highly relevant to clinical mood
disorders and they are well-recognised in the aetiology and maintenance of depression, such
that depressed individuals are more likely to interpret, focus on and remember negative
compared to positive emotional cues in self-relevant neuropsychological tasks. Antidepressant
treatments have been shown to cause early, subconscious positive changes in emotional
processing biases, which are evident in computerised tasks after one single dose of
antidepressant. Recent theory suggests that over time this positive change in emotional bias
contributes to improved mood.
Since elevated inflammatory markers appear to negatively affect mood and neuropsychological
function, the investigators believe there is a need to expand our understanding of the
psychological effects of reducing inflammatory markers. To do so, subjects will be
administered either a single dose of 200 mg minocycline or placebo, after which they will
complete a well-validated computerized battery of psychological tasks, which includes
paradigms such as facial expression recognition, emotional categorization and emotional
memory tasks that have previously been shown to be sensitive to conventional antidepressant
treatments in healthy volunteers.
The results of this study will be compared to effects of common antidepressant treatments
found using this same model within the investigators' lab and others. If effects are found to
be comparable, this could not only provide further support for the emotional processing
theory of antidepressant action, but it could also help to identify novel therapeutic targets
for new treatments that could benefit depressed patients who do not respond successfully to
current antidepressants.
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